Cardiovascular disease remains the most relevant public health problem. Most cardiovascular diseases are associated with an atherosclerosis, the development of which is associated with inflammation and endothelial dysfunction. Melatonin is a neurohormone that is synthesized mainly in the pineal gland and plays a central role in the regulation of sleep and some other body cyclic processes. For a long time, melatonin was perceived as a substance that is effective in the treatment of circadian cycle impairments. At the same time, a large number of studies have accumulated recently that demonstrate a wider range of its biological effects, including anti-inflammatory, antioxidant, antihypertensive and, possibly, hypolipidemic. The review includes current data from experimental and clinical studies demonstrating the cardioprotective effects of melatonin in atherosclerosis, myocardial ischemia, and heart failure.
The purpose of the present work was the assessment of clinical efficiency of therapy including melatonin in patients with non-alcoholic steatohepatitis and concomitant type 2 diabetes mellitus. The study included 59 patients divided into two groups. The first group of 33 patients received basic treatment, the second group of 25 patients was given melatonin in addition to basic therapy. During the study the analysis of dynamics of clinical symptoms was carried out, the state of a free radical homeostasiswas evaluated by biochemiluminescense, and activity of enzymatic components of the antioxidant system (catalase and superoxide dismutase (SOD)) measured to compare effects of basic treatment and its combination with melatonin. Patients with non-alcoholic steatohepatitis showed the increase of gamma-glutamyl transpeptidase activity that reflected hepatic dysfunction, intensification of free radical oxidation processes, an imbalance the antioxidant system, namely decrease of the SOD activity and increase of the catalase activity. The combined treatment with melatonin produced more significant clinical effect in comparison with basic therapy as confirmed by changes in the clinical picture of the disease. At the same time, a greater decrease of the gamma-glutamyl transpeptidase activity, biochemiluminescent indicators, changes of SOD and catalase activities under effect of combined therapy with melatonin than in the patients given basic treatment was apparent. These findings can be attributed to melatonin antioxidant effect responsible for inhibition of free radical oxidation, reduction of the severity of imbalance in the function of antioxidant enzymes and suppression of the inflammatory process in the liver.
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